Epi program (blood)

1. EXPANDED PROGRAM
ON
IMMUNIZATION (EPI)
PAKISTAN
By
Dr. Syed Sanowar Ali
Associate Professor
Department of Community Health Sciences
United Medical Dental College

2. IMMUNITY
It is the Defense mechanism of the body.
Protection from an infectious disease. If you
are immune to a disease, you can be
exposed to it without becoming infected
Vaccine: A product that stimulates a
person’s immune system to produce immunity
to a specific disease, protecting the person
from that disease.

3. Immunization: A process by which a
person becomes protected against a disease
through vaccination.
Active Immunity: When dead or live
attenuated antigen is given to body to produce
antibodies.
Passive Immunity: When already
prepared antibodies are given to body
Vaccination: The act of introducing a
vaccine into the body to produce immunity to
a specific disease.

4. Active Immunity
Immunity developed after contacting
pathogens inside the body
Artificial Immunity
Passive Immunity
Natural Immunity
e.g. Injection of attenuated live /
killed organism or toxoide.g. Infection
Natural Immunity Artificial Immunity
e.g. Injection of antibodies or
antitoxin
e.g. Antibodies from
mother
Immunity provided by antibodies or antitoxins
provided from outside the body

5. PASSIVE
IMMUNIZATION
ACTIVE IMMUNIZATION
IMMUNIZATION
OR
VACCINATION
Vaccination: The act of introducing a
vaccine into the body to produce immunity to
a specific disease.
Immunization: A process by which a
person becomes protected against a disease
through vaccination.

6. In EPI program
ONLY
ACTIVE
IMMUNIZATION
is done

7. EPI Global EPI Launched By WHO in MAY 1974.
 With Objective Of Reducing to a negligible level
morbidity & Mortality from Diphtheria, Pertusis,
Tetanus, Poliomyelitis, TB & Measles to make
immunization against these disease available to every
child in the world by 1997.
 Pakistan Started Its EPI programme in June-July 1978
with help of WHO & UNICEF.
 Hep B Was also Inducted In Pakistan EPI in August
2002.
 Then HiB & Pneumococcal Vaccines

8. 1. LIVE VACCINES
2. DEAD VACCINES
3. TOXOIDS
4. Others
VACCINES

9. Route of
Administration -
Vaccines

10. Intra-Muscular
(90°angle)
Sub-Cutaneous
(45°angle)
Intra-Dermal
(15 -20°angle)
Oral

11. 2. Female
Immunization
EPI program has two parts
1. Child Immunization

12. 1. CHILD IMMUNIZATION

13. EPI Vaccination Schedule
Age Vaccines to
be given
Dose Form Site Route of
Administration
At Birth BCG
OPV0
0.05 ml Powdered Deltoid
(Rt. Arm)
Intra-Dermal
Oral
At 6
Weeks
PENTA1 (DPT1 + HBV1 + HiB1)
OPV1
0.5 ml Liquid Ant. Lat.
Lt. Thigh
Intra-Muscular
Oral
PCV1 0.5 ml Liquid Rt. Thigh Intra-Muscular
At 10
Weeks
PENTA2 (DPT2 + HBV2 + HiB2)
OPV2
0.5 ml Liquid Ant. Lat.
Lt. Thigh
Intra-Muscular
Oral
PCV2 0.5 ml Liquid Rt. Thigh Intra-Muscular
At 14
Weeks
PENTA3 (DPT3 + HBV3 + HiB3)
OPV3
0.5 ml Liquid Ant. Lat.
Lt. Thigh
Intra-Muscular
Oral
PCV3 0.5 ml Liquid Rt. Thigh Intra-Muscular
At 9
Months
Measles 0.5 ml Powdered Deltoid
(Lt. Arm)
Sub- Cutaneous
At 15
Months
(Booster)
Measles 0.5 ml Powdered Deltoid
(Lt. Arm)
Sub- Cutaneous

14. EPI Vaccination Schedule
Vaccine
BCG - (Live vaccine)
BCG Bacillus Calmette –Guérin
Against Disease Tuberculosis
Ideal age
(only one dose)
At Birth
(within 1 week)
Dose 0.05 ml
Form Powdered
Site Deltoid muscle (Rt. Arm)
Route of
Administration
Intra-Dermal
Side Effect Rare – Scar after 3-6 months
Immunity Achieved 80% against Pulmonary TB
100% against Tuberculous Meningitis
(TBM)
Important : Instruction
to mother about Scar

15. EPI Vaccination Schedule
Vaccine
OPV - (Live
vaccine)
OPV Oral Polio Vaccine
Against Disease Poliomyelitis
Ideal age (four
doses)
At Birth OPV0(within 1 week), 6
(OPV1),10 (OPV2) & 14 (OPV3) weeks
Dose Two drops
Form Liquid
Site Mouth
Route of
Administration
Orally
Side Effect No
Immunity Achieved 70% in Developing countries
100% in Developed countries

16. EPI Vaccination Schedule
Vaccine
PENTA
PENTA D + P+ T + HBV + HiB
(Toxoid-D&T, Dead-P& others HBV &
HiB)
Against Disease Diphtheria, Pertussis, Tetanus,
Hepatitis B & Haemophilus Influenza
type B
Ideal age (three
doses)
6 (Penta1),10 (Penta2) & 14 (Penta3)
weeks
Dose 0.5 ml
Form Powdered
Site Anterio-Lateral site – Mid Left Thigh
Route of
Administration
Intra-Muscular
Side Effect Fever, tenderness injection site &
Rarely fits
Immunity Achieved 95 – 98 %

17. EPI Vaccination Schedule
Vaccine
PCV
(other method)
PCV Pneumococcal Vaccine
Against Disease Due to Pneumococcal bacteria
(Pneumonia, Meningitis etc.)
Ideal age (three
doses)
6 (PCV1),10 (PCV2) & 14 (PCV3)
weeks
Dose 0.5 ml
Form Liquid
Site Anterio-Lateral site – Mid Right
Thigh
Route of
Administration
Intra-Muscular
Side Effect Generally No
Immunity Achieved 95 - 98%

18. EPI Vaccination Schedule
Vaccine
Measles (Live
Vaccine)
Against Disease Measles
Ideal age (two
doses)
At 9 months & 15 months (Booster)
Dose 0.5 ml
Form Powdered
Site Deltoid muscle (Lt. Arm)
Route of
Administration
Sub- Cutaneous
Side Effect Generally No
Immunity Achieved 95 - 98%

19. 2. FEMALE IMMUNIZATION

20. EPI Vaccination Schedule
Vaccine
TT
TT Tetanus Toxoid
Against Disease Tetanus
Ideal age (five
doses)
According to schedule
Dose 0.5 ml
Form Liquid
Site Deltoid muscle – Left
Arm
Route of
Administration
Intra-Muscular
Side Effect Generally No
Immunity Achieved 100%

21. Vaccination Schedule for Females 15- 45
years (Child Bearing Age - CBA)
Tetanus
Toxoid
TT1 TT2
TT3
TT4 TT5
Intra-
Muscular
At 1st
Contact
as early as
possible OR
during 7th
months of
Pregnancy
At least 4
Weeks
after TT1
At least 6-
12 Months
after TT2
At least 1
year after
TT3
At least 1
year after
TT4
Immunity
Achieved
No 3 years 5 years 10 years 20 years
OR Live
long

22. Contraindications
 General Contraindications
Acute Illness esp. High grade
fever
 Individual Vaccines
Whooping Cough (Pertussis)
Appearance of Neurological
Symptoms
But generally there
is No absolute
Contraindications

23. THANK YOU!!!!!!!